Demirdağ Filiz, Yavuzer Serap, Cengiz Mahir, Yavuzer Hakan, Kara Zehra, Ayvacı Adnan, Avcı Suna, Yürüyen Mehmet, Uzun Hafize, Altıparmak Mehmet Rıza, Döventaş Alper, Erdinçler Deniz Suna
Division of Geriatrics, Department of Internal Medicine, Istanbul University-Cerrahpasa, School of Medicine, Istanbul, Turkey.
Division of Geriatrics, Department of Internal Medicine, Istanbul Medeniyet University, School of Medicine Istanbul, Turkey.
Horm Metab Res. 2023 Oct;55(10):733-740. doi: 10.1055/a-2109-1958. Epub 2023 Jun 12.
The etiopathogenesis of metabolic syndrome (MetS) has not been fully understood yet, and chronic low-grade inflammation is thought to be associated with the development of complications related to MetS. We aimed to investigate the role of Nuclear factor Kappa B ( NF-κB ), Peroxisome Proliferator-Activated Receptor- α and γ (PPAR-α, and PPAR-γ) which are the main markers of inflammation in older adults with MetS. A total of 269 patients aged≥18, 188 patients with MetS who met the diagnostic criteria of the International Diabetes Federation, and 81 controls who applied to geriatrics and general internal medicine outpatient clinics for various reasons were included in the study. Patients were separated into four groups: young with MetS (< 60, n=76), elderly with MetS (≥60, n=96), young control (< 60, n=31), elderly controls (≥60, n=38). Carotid intima-media thickness (CIMT) and NF-κB , PPAR-α, and PPAR-γ plasma levels were measured in all of the participants. Age and sex distribution were similar between MetS and control groups. C-reactive protein (CRP), NF-κB levels (p=0.001) and CIMT (p<0,001) of MetS group were significantly higher than in the control groups. On the other hand, the PPAR-γ (p=0.008) and PPAR-α (p=0.003) levels were significantly lower in MetS. ROC analysis revealed that the NF-κB, PPAR-α, and PPAR-γ could be used to indicate MetS in younger adults (AUC: 0.735, p<0.000; AUC: 0.653, p=0.003), whereas it could not be an indicator in older adults (AUC: 0.617, p=0.079; AUC:0.530, p=0.613). It seems that these markers have important roles in MetS-related inflammation. In our results, suggest that the indicator feature of NF-κB , PPAR-α and PPAR-γ in recognizing MetS in young individuals is lost in older adults with Mets.
代谢综合征（MetS）的发病机制尚未完全明确，慢性低度炎症被认为与MetS相关并发症的发生有关。我们旨在研究核因子κB（NF-κB）、过氧化物酶体增殖物激活受体-α和γ（PPAR-α和PPAR-γ）在患有MetS的老年人炎症中作为主要标志物的作用。共有269名年龄≥18岁的患者纳入研究，其中188名符合国际糖尿病联盟诊断标准的MetS患者，以及81名因各种原因前往老年病科和普通内科门诊就诊的对照者。患者被分为四组：年轻MetS组（<60岁，n = 76）、老年MetS组（≥60岁，n = 96）、年轻对照组（<60岁，n = 31）、老年对照组（≥60岁，n = 38）。测量了所有参与者的颈动脉内膜中层厚度（CIMT）以及NF-κB、PPAR-α和PPAR-γ的血浆水平。MetS组和对照组之间的年龄和性别分布相似。MetS组的C反应蛋白（CRP）、NF-κB水平（p = 0.001）和CIMT（p < 0.001）显著高于对照组。另一方面，MetS组的PPAR-γ（p = 0.008）和PPAR-α（p = 0.003）水平显著较低。ROC分析显示，NF-κB、PPAR-α和PPAR-γ可用于指示年轻成年人中的MetS（AUC：0.735，p < 0.000；AUC：0.653，p = 0.003），而在老年人中则不能作为指标（AUC：0.617，p = 0.079；AUC：0.530，p = 0.613）。这些标志物似乎在MetS相关炎症中起重要作用。在我们的结果中，提示NF-κB、PPAR-α和PPAR-γ在识别年轻个体中的MetS时的指示特征在患有MetS的老年人中丧失。
